When physicians say 'no' to requests, patient satisfaction suffers

Patients may report lower satisfaction with their care when physicians deny their requests for referrals, lab tests or prescriptions, according to a study published in JAMA Internal Medicine.

Researchers gathered data from 1,141 adults who made a total of 1,319 outpatient visits to 56 family physicians at an academic medical center in Northern California. Patients were 46 years old on average, and approximately 68 percent of patients were female.

Nearly two-thirds of the visits included at least one patient request for the physician to provide a specialist referral, a lab test, pain medication or other prescription medication. Physicians said "yes" to these requests 85 percent of the time, according to the study.

When physicians denied these requests, scores on patient satisfaction surveys after office visits were significantly lower than when requests were fulfilled.

Part of the problem might be how frequently physicians comply with patient requests, lead study author Anthony Jerant, MD, told Reuters. "A request denial, therefore, is quite out of the ordinary and probably likely to invoke a negative reaction," Dr. Jerant said.

To improve patient and physician experiences, physicians need to be trained to effectively deal with requests and work to better explain their reasoning for denying a request, the authors concluded.